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General NPI Number Information
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NPI Number | 1730358524
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Entity Type | Organization
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Legal Business Name | WALTER F RUTKOWSKY O D PA
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Dates
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Enumeration Date | 02/26/2008
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Last Update Date | 08/16/2010
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Provider Practice Location Address
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Address Line | 5005 MANATEE AVE W
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City | BRADENTON
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State | FL
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Zip | 34209-3857
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Country | US
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Telephone | 941-794-1315
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Fax | 941-792-5034
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Provider Business Mailing Address
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Address Line | 5005 MANATEE AVE W
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City | BRADENTON
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State | FL
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Zip | 34209-3857
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Country | US
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Telephone | 941-794-1315
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Fax | 941-792-5034
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Authorized Official
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Title or Position | OWNER
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Name | WALTER F RUTKOWSKY
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Credential | O.D.
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Telephone | 941-794-1315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC1555
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License Number State | FL
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